Medical Payola

This morning’s NYT has an article summarizing new data about pharmaceutical industry payments to physicians in Minnesota -with such revelations now mandated by law and written up today (with data from Vermont as well) in JAMA. Not surprisingly, such an original contribution is accompanied by a sunshiney editorial. You might also appreciate the nice NYT graphic summarizing the “highlights” of pharm largess. Should anyone be surprised that a recent NYT/CBS news poll found that 85% of those queried believed it was “not acceptable” for doctors to be paid by drug companies to comment on prescription drugs and that such payments would influence the decisions that doctors made about patient care? And incredibly, at the same time we have accepting tobacco money being designated a form of academic freedom, we have drug companies referring to payments made to physicians as “trade secrets.”

And More: Good grief. Today we learn in the NYT that a “significant number” of FDA advisors receive more than $50,000 from a company or a competitor whose product is being discussed for approval.

“In one famous example, 10 of the 32 advisers who voted in 2005 to allow the painkiller Bextra to remain on the market and the painkiller Vioxx to return to the market despite safety worries had taken money from the drug makers. Under the new rules, their votes would not have counted and the committee would have voted to keep both drugs off the market.”

And incredibly: “Advisory panels are important to the F.D.A. not so much because they provide the agency with expert advice — the F.D.A. can get that privately any time — but because they serve to increase public confidence in the agency’s decisions.”

What stunning logic: use the people with the greatest conflicts of interest to decide the fate of drugs & devices in an effort to increase public confidence.

Another confidence booster? The self-admitted inability of FDA advisors to recognize potential conflicts of interest, all too common today from the grad student/postdoc in the lab on up: “Under the old system, committee members rarely knew what kind of conflicts would lead to problems.”